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Trial registered on ANZCTR
Registration number
ACTRN12606000333516
Ethics application status
Approved
Date submitted
22/07/2006
Date registered
7/08/2006
Date last updated
3/06/2009
Type of registration
Prospectively registered
Titles & IDs
Public title
Ant Venom Immunotherapy: Improving method and maintenance.
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Scientific title
A randomised 2x2 comparison of ultra-rush with semi-rush initiation, and 50 microgram versus 100 microgram maintenance venom immunotherapy for preventing anaphylaxis in jack jumper ant venom allergic people.
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Allergy (anaphylaxis) to the jack jumper ant (JJA)
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Myrmecia pilosula.
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Condition category
Condition code
Inflammatory and Immune System
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0
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Allergies
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Venom immunotherapy by subcutaneous injection; randomised 2 x 2 factorial design; ultra-rush (treatment initiation over 2 days) versus semi-rush (treatment initiation over 10 weeks), and 50 mcg versus 100 mcg maintenance dosing every three months for 3-5 years. A patient's choice arm is also available for part of the study where the patient may select either or both of initiation method and maintenance dose.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
Not applicable
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Control group
Active
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Outcomes
Primary outcome [1]
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Systemic reaction rates to immunotherapy during treatment initiation.
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Assessment method [1]
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Timepoint [1]
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3 visits (3 weeks) in ultra-rush and 10 visits (10 weeks) in semi-rush respectively.
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Primary outcome [2]
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Systemic reaction rates to sting challenge.
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Assessment method [2]
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Timepoint [2]
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After 12-15 months of maintenance therapy.
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Secondary outcome [1]
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Systemic reaction rates to immunotherapy during treatment initiation and to deliberate sting challenges in the patient choice arms.
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Assessment method [1]
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Timepoint [1]
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Definition of "treatment initiation" changed to 3 visits (3 weeks) in ultra-rush and 10 visits (10 weeks) in semi-rush respectively.
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Secondary outcome [2]
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Number of visits and total dose of venom extract up until sting challenge.
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Assessment method [2]
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Timepoint [2]
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12-15 months
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Secondary outcome [3]
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Time interval from treatment initiation to achieving 1 month, 2 month and 3 month dosing intervals.
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Assessment method [3]
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Timepoint [3]
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Measured over 12-15 months
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Secondary outcome [4]
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Reactions to accidental field stings over duration of treatment (3-5 years) and during long term follow up after stopping immunotherapy (10 years).
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Assessment method [4]
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Timepoint [4]
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10 years
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Eligibility
Key inclusion criteria
Adults and children with a history of one or more systemic allergic reactions to a known or suspected JJA sting.
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Minimum age
No limit
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Negative intradermal skin and serum (RAST) tests for venom-specific IgE; pregnancy at time of treatment initiation; psychiatric illness rendering the patient unable to understand the study; severe cardiac or respiratory disease such that there is a high risk of decompensation to the mild-moderate allergic reactions that commonly occur with immunotherapy.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation of treatment initiation method is not concealed, however the dose given will be single-blind (treating staff will be aware of dose, but the patient will not be told).
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Random number table
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Factorial
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Other design features
A "patient choice arm" is also provided so that patients may choose the initiation method and maintenance dose.
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Phase
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
4/09/2006
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
800
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Department of Health and Human Services, Tasmanian Government
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Address [1]
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Hobart, Tasmania
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Country [1]
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Australia
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Primary sponsor type
Government body
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Name
Department of Health and Human Services, Tasmanian Government
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Address
GPO Box 125
HOBART TAS 7001
AUSTRALIA
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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University of Western Australia
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Address [1]
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Crawley, Western Australia
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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HUMAN RESEARCH ETHICS COMMITTEE (TASMANIA) NETWORK -Royal Hobart Hospital
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Ethics committee address [1]
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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21/07/2006
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Ethics approval number [1]
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H0008934.
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Ethics committee name [2]
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HUMAN RESEARCH ETHICS COMMITTEE (TASMANIA) NETWORK -Launceston General Hospital
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Ethics committee address [2]
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
2950
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Approval date [2]
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21/07/2006
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Ethics approval number [2]
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H0008934.
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Ethics committee name [3]
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HUMAN RESEARCH ETHICS COMMITTEE (TASMANIA) NETWORK -North West Regional Hospital
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Ethics committee address [3]
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Ethics committee country [3]
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Australia
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Date submitted for ethics approval [3]
2951
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Approval date [3]
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21/07/2006
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Ethics approval number [3]
2951
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H0008934.
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Summary
Brief summary
The objectives of this study are to improve the delivery of venom immunotherapy (VIT) by assessing the efficacy and safety of different approaches to venom immunotherapy, namely ultra-rush (ultra-rapid initiation over 2 days) versus semi-rush (initiation over 10 weeks) and half-dose (50 microgram) versus standard dose (100 microgram) maintenance treatment. Specific hypotheses are that: (i) ultra-rush initiation will be equivalent to outpatient semi-rush initiation in terms of allergic reaction rates to immunotherapy; (ii) A maintenance dose of 50 mcg will be as efficacious as a 100 mcg maintenance dose, and; (iii) VIT with both initiation methods and maintenance doses will have a sustained positive impact (reduced reaction risk) after cessation of VIT. The study will have important implications. If the different approaches are equivalent, we will be able to significantly reduce the amount of venom extract used and thus increase the number of patients that we can treat, given that our venom supplies are expensive and limited. Because it will be impossible to conceal treatment allocations, the different initiation methods will be unblinded. Maintenance doses will be single blinded (known to the treating doctor but not the patient) because of the significant day-to-day dose adjustments required during immunotherapy would make double-blinding difficult and potentially dangerous. The main outcome measures will be (1) the occurence of systemic allergic reactions to immunotherapy (safety of treatment) and (2) systemic allergic reactions to deliberate sting challenges and accidental stings (effectiveness of treatment)
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Associate Professor Simon G A Brown
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Address
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University of Western Australia
Discipline of Emergency Medicine
(M516) 2nd Floor R Block
QE11 Medical Centre
Nedlands WA 6009
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Country
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Australia
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Phone
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+61 419796678
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Associate Professor Simon G A Brown
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Address
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University of Western Australia
Discipline of Emergency Medicine
(M516) 2nd Floor R Block
QE11 Medical Centre
Nedlands WA 6009
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Country
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Australia
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Phone
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+61 419796678
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Factors influencing the quality of Myrmecia pilosula (Jack Jumper) ant venom for use in in vitro and in vivo diagnoses of allergen sensitization and in allergen immunotherapy.
2017
https://dx.doi.org/10.1111/cea.12987
Embase
Towards complete identification of allergens in Jack Jumper (Myrmecia pilosula) ant venom and their clinical relevance: An immunoproteomic approach.
2018
https://dx.doi.org/10.1111/cea.13224
N.B. These documents automatically identified may not have been verified by the study sponsor.
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